Tag Archives: Anxiety Reduction

Ask Ellen Anmuth, Psychotherapist: Coping With A Cancer Diagnosis

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Ask Ellen Anmuth, Psychotherapist

Ask Ellen Anmuth, Psychotherapist

A cancer diagnosis can be terrifying. The journey can begin with a swollen lymph node, a breast lump discovered while showering, or a visit to the doctor, where the words “we need to get this biopsied” reverberate in you head in stunned panic.

This blog series answers email questions from readers. Robin from Westchester, NY writes:

Dear Ellen Anmuth, Psychotherapist: I had a mammogram a month ago, and was called back for another scan, because they found something that concerned them. Yesterday, I went back for a repeat scan, and they found some abnormality…not sure, but I think they said something about calcification. I set up a biopsy for next week, and I am really afraid that this may be cancer. Please help me.

Ellen Anmuth, Psychotherapist: Dear Robin….It is normal to feel anxiety when told that you need a biopsy. The fear of cancer looms heavy when told that we need to do a biopsy, which is an invasive procedure. Let’s outline some approaches:

1) You live in Westchester, NY which is very close to New York City, with some of the best Medical Schools and Universtiy Medical Centers in the world. Many people like to take their mammogram scans to a University Medical Center, and get a second opinion. You may even want to get another mammogram at the medical center in New York City, and get a second opinion from a specialist in this area. Often times, the University Hospitals are aware of the current research, and if you find a world renowned expert in the diagnosis of breast cancer, you may feel more comfortable. It would be a shame to undergo a biopsy if an expert has an opinion different from  your community doctor. Of course, you can always get a third opinion if the first 2 doctors disagree.

2) Let’s look at some emotional coping skills. First, a cancer diagnosis is no longer is a death sentence. There are many approaches to breast cancer, and treatments are improving all the time. Even in a serious cancer diagnosis, there have been people who have defied the odds, and survived. Dr. Bernie Siegel wrote a book called “Love, Medicine and Miracles” in which he documented cancer patients who told their doctor that they were not going to die, and survived. Remember….the journey of a possible cancer diagnosis is a challenging one, and yet if you are open to support, the journey can be easier. The hospital social work services department can refer you to cancer support groups and licensed mental health providers who can help.

One approach emotionally is to “stay in the moment” and notice if you are visualizing a disaster scenarios. If you start to imagine death and pain, stop and ask yourself if there is fact to support your catastrophic images, or just your fear. Yes, fear is understandable, but try to manage the tendency to imagine the worst. Think back on your family of origin coping skills. Did your parents have a pessimistic tendency, always jumping to the worst possible conclusion? Or, did they tend to be optimists or realists? Reflecting on some automatic patterns you may have learned can be helpful. Finally, some people like to seek religious and/or spiritual support, and find comfort by doing so. Remember that current crises can bring up some repressed memories of past unresolved issues. A licensed mental health professional can be of help with coping with the wide array of issues that emerge when faced with a possible cancer diagnosis.

Ask Ellen Anmuth, Psychotherapist: Reduce Stress in College

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“Ask Ellen Anmuth, Psychotherapist”  is a series of blog entries by Ellen Anmuth MS, MSW, LCSW,  a Licensed Clinical Social Worker. Select emails will be answered which may appeal to a broad audience.

This blog does not replace mental health counseling services, and I strongly recommend seeking the help of local licensed mental health providers when indicated. The Social Work Services Department of most hospitals can be a helpful referral source, especially if financial need is an issue.

This article will deal with two different topics from Sharon in Texas and  Don in California.

Sharon S. from Texas: “I find myself seeking approval from my family. They tend to be very controlling and critical, and I am afraid to make a decision that they may not approve of”.

Ellen Anmuth MS, MSW, LCSW: Sharon, I see that you are 20 years old, and living at home while attending community college. This can be a difficult period of life for you, in terms of a concept called, “separation-individuation”. You are in a period of life that some therapists call “The Young Adult Transition”. There are certain developmental tasks in each period of adult life, and stress can result when our inner compass differs from parents’ views.  Do you have friends you can relate to, and who share your values? What type of things do your parents disapprove of?  Are you engaging in any dangerous activity that would support their concern, or do you feel that their controlling behavior is related to treating you like a teenager, rather than a young adult? Sometimes, if parents have a difficult time adjusting to an adult child’s need for separation and individuation, conflict can emerge. Perhaps there might be counseling services through the community college, where you may be able to meet with a licensed therapist in person, to better evaluate the situation and guide you through your options and coping strategies.

Don M. from California: “I am pre-med, and so anxious about my tests that I can’t concentrate to study, and my grades are suffering. Do you have any ideas how I can study when I have so much anxiety about failing?”

Ellen Anmuth MS,MSW, LCSW:  Don, this is a question that so many others have asked me. I have an Education degree, and was an Assistant Professor of Family Medicine, teaching  medical students and doctors about psychology and education. I developed a technique to help people deal with test anxiety that was blocking their concentration. Try this: Take a sheet of paper, and make two columns: 1) The advantages of holding onto the feeling of anxiety, and 2) The disadvantages of holding onto the feeling of anxiety.  Fill out both columns quickly, writing the first things that come to mind. You will see a pattern, which will reveal information that may provide some insight. You may find that there is no logical “advantage” of holding onto the feeling of anxiety! That realization helps us to compartmentalize it away, at least temporarily, in order to concentrate.

Another useful technique is to make a “contract” with yourself, that every day, from 8pm-10pm you will study the course material that worries you the most. Do an “imagery exercise”: Imagine putting the feeling of anxiety in a box that you can put away (metaphorically speaking). You may imagine putting a box with your anxiety on a shelf in your closet, where you can close the door, so that with your anxiety “away” for the few hours, you can focus on the subject matter. After 2 hours, if you want to find that box, open it up, and experience the feeling of anxiety again, you can. You have that control. However, after 2 hours of focused study, you may find that the anxiety can stay in the closed box, and that you feel more confident and relaxed!  In fact, you may decide to throw that black box with anxiety out into the trash, rather than keep it on your closet shelf. This is a guided imagery exercise, which may be helpful. With incremental hours of successful concentration, you will feel more in control, and more confident about passing your tests.